| NPI | 1508408121 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11002368) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141355) |
| Enumeration Date | 2019-10-15 |
| Last Update Date | 2020-12-02 |