| NPI | 1659871168 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP141489) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 807558) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP141489) | |
| Enumeration Date | 2018-02-20 |
| Last Update Date | 2022-01-19 |