| NPI | 1700144409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 2011012536) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NV 819374) |
| Enumeration Date | 2012-05-01 |
| Last Update Date | 2024-02-12 |