| NPI | 1629835541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1153289) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024189661) |
| Enumeration Date | 2024-03-06 |
| Last Update Date | 2024-03-06 |