| NPI | 1396240099 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX API36384) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP13684) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP136384) | |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX API36384) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2021-07-15 |