| NPI | 1417656158 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1111712) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1111712) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2024-11-13 |