| NPI | 1639732530 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 903163) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141317) |
| Enumeration Date | 2019-04-16 |
| Last Update Date | 2022-05-17 |