| NPI | 1568096279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA RN196865) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AG02200003) |
| Enumeration Date | 2020-03-03 |
| Last Update Date | 2021-06-01 |