| NPI | 1578099719 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136685) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 703127) |
| Enumeration Date | 2017-05-09 |
| Last Update Date | 2018-10-08 |