| NPI | 1558031922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1059486) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX F08210772) |
| Enumeration Date | 2021-09-16 |
| Last Update Date | 2023-04-04 |