| NPI | 1477988475 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP123519) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 661899) |
| 291U00000X Clinical Medical Laboratory (Licence: TX 0033289) | |
| Enumeration Date | 2013-09-09 |
| Last Update Date | 2025-01-08 |