| NPI | 1407406051 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP143050) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 779993) |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2022-10-10 |