| NPI | 1558713966 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130648) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care (Licence: TX AP130648) |
| 363L00000X Nurse Practitioner (Licence: TX AP130648) | |
| Enumeration Date | 2016-07-09 |
| Last Update Date | 2017-01-26 |