| NPI | 1790390300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1016143) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 1790390300) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1790390300) | |
| 163W00000X Registered Nurse (Licence: TX 893884) | |
| Enumeration Date | 2020-09-10 |
| Last Update Date | 2021-11-11 |