| NPI | 1790469658 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1110156) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95025505) |
| Enumeration Date | 2023-06-12 |
| Last Update Date | 2024-03-11 |