| NPI | 1790268589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1125273) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 950007) |
| Enumeration Date | 2018-09-08 |
| Last Update Date | 2024-11-09 |