| NPI | 1609429307 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1017259) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NE 112884) |
| Enumeration Date | 2019-07-22 |
| Last Update Date | 2021-08-06 |