| NPI | 1508520917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP1108472) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY 348175) |
| Enumeration Date | 2021-10-22 |
| Last Update Date | 2023-05-04 |