| NPI | 1417598905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1038661) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 26614) |
| Enumeration Date | 2019-10-04 |
| Last Update Date | 2021-10-13 |