| NPI | 1639730153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1025432) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN227137) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2023-06-06 |