| NPI | 1780094490 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132550) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OH 15638) |
| Enumeration Date | 2014-05-02 |
| Last Update Date | 2020-01-06 |