| NPI | 1720552797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1035819) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F343920-1) |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2022-12-15 |