| NPI | 1578005443 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024177411) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132558) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2020-01-22 |