| NPI | 1821570458 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX AP142838) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: WA AP60896000) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2021-06-30 |