| NPI | 1518317304 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1156716) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL APRN9371206) | 
| 363LF0000X Nurse Practitioner, Family (Licence: GA RN293548) | |
| Enumeration Date | 2016-06-13 | 
| Last Update Date | 2024-04-19 |