| NPI | 1619513819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1016046) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MO 2919043669) |
| Enumeration Date | 2019-11-22 |
| Last Update Date | 2023-03-10 |