| NPI | 1548969157 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1017829) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1017829) |
| Enumeration Date | 2023-03-02 |
| Last Update Date | 2023-05-24 |