| NPI | 1760153498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1056977) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: TX 510296) |
| Enumeration Date | 2021-09-22 |
| Last Update Date | 2023-10-05 |