| NPI | 1760144539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 2021099173) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 302843) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 913344) | |
| Enumeration Date | 2021-10-09 |
| Last Update Date | 2021-10-31 |