| NPI | 1730804915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1096251) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1096251) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-09-20 |