| NPI | 1821341801 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11009471) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1143754) |
| Enumeration Date | 2012-10-16 |
| Last Update Date | 2024-01-16 |