| NPI | 1679636146 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 27478) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27478) |
| 174400000X Specialist (Licence: FL RN2958212) | |
| 363L00000X Nurse Practitioner (Licence: TX 657809) | |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 657809) | |
| Enumeration Date | 2006-12-18 |
| Last Update Date | 2021-12-20 |