| NPI | 1386253201 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1023320) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 807934) |
| Enumeration Date | 2020-07-27 |
| Last Update Date | 2021-07-02 |