| NPI | 1710582572 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1047836) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 731207) |
| 363L00000X Nurse Practitioner (Licence: TX 1047836) | |
| 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1047836) | |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2024-04-19 |