| NPI | 1639564172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WA AP61103840) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 764480) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP127833) | |
| Enumeration Date | 2015-04-01 |
| Last Update Date | 2021-07-27 |