| NPI | 1770916090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA AP07517) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP124669) |
| Enumeration Date | 2013-08-11 |
| Last Update Date | 2021-03-16 |