| NPI | 1780961938 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1088418) |
| Additional Taxonomies | 224Z00000X Occupational Therapy Assistant (Licence: TX 21154) |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2022-10-19 |