| NPI | 1538510987 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F02190491) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 836955) |
| Enumeration Date | 2016-06-27 |
| Last Update Date | 2019-06-01 |