| NPI | 1457013567 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1057179) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1057170) |
| Enumeration Date | 2021-10-06 |
| Last Update Date | 2022-05-25 |