| 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 |