| NPI | 1639533953 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136986) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 21173) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2020-05-05 |