| NPI | 1790401826 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1097192) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1097192) |
| Enumeration Date | 2022-10-19 |
| Last Update Date | 2022-10-19 |