| NPI | 1619411618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: TX AP132641) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 720883) |
| Enumeration Date | 2016-12-09 |
| Last Update Date | 2024-03-11 |