| NPI | 1417458340 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1059857) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 849639) |
| 363L00000X Nurse Practitioner (Licence: TX 1059857) | |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2022-09-16 |