| NPI | 1760074470 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP1030530) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 592063) |
| Enumeration Date | 2021-02-04 |
| Last Update Date | 2022-12-06 |