| NPI | 1780275859 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP1030129) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 892219) |
| Enumeration Date | 2021-02-01 |
| Last Update Date | 2022-04-11 |