| NPI | 1790208460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP134601) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 648929) |
| Enumeration Date | 2017-07-25 |
| Last Update Date | 2017-08-09 |