| NPI | 1518509637 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 366691-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 366691-3102) |
| Enumeration Date | 2019-10-09 |
| Last Update Date | 2020-10-15 |