| NPI | 1649926585 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1020063) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 733807) |
| Enumeration Date | 2022-03-01 |
| Last Update Date | 2022-03-22 |