| NPI | 1760965198 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: GA RN216436)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139796)  | 
| Enumeration Date | 2018-09-11 | 
| Last Update Date | 2024-05-16 |