| NPI | 1649663105 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP128144) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 174458) |
| Enumeration Date | 2015-03-09 |
| Last Update Date | 2018-10-01 |