| NPI | 1376263137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1096153) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX F08221039) |
| Enumeration Date | 2022-08-31 |
| Last Update Date | 2022-10-18 |