| NPI | 1629528369 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F09220579) |
| Additional Taxonomies | 251S00000X |
| 163W00000X Registered Nurse (Licence: TX 789922) | |
| Enumeration Date | 2016-10-06 |
| Last Update Date | 2022-09-17 |