| NPI | 1457944076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1021649) |
| Additional Taxonomies | 2085R0001X (Licence: TX 791516) |
| Enumeration Date | 2021-02-15 |
| Last Update Date | 2024-04-08 |