| NPI | 1598361354 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1015740) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 1015740) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1015740) | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2023-06-14 |