| NPI | 1700214004 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX AP131316) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 696109) |
| Enumeration Date | 2013-10-23 |
| Last Update Date | 2023-02-24 |