| NPI | 1790111557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 826142) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 93280) |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0101373) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NM 68821) | |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183008) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2023-10-28 |