| NPI | 1407512320 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1074720) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 883624) |
| 207Q00000X Family Medicine (Licence: TX 1074720) | |
| Enumeration Date | 2021-11-15 |
| Last Update Date | 2022-04-19 |