| NPI | 1770909665 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 29429) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 635338) |
| 363L00000X Nurse Practitioner (Licence: TX AP122916) | |
| Enumeration Date | 2014-03-15 |
| Last Update Date | 2021-05-17 |