| NPI | 1770256968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1047323) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 1047323) |
| Enumeration Date | 2021-07-26 |
| Last Update Date | 2024-05-21 |