| NPI | 1861094757 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1029027) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 914285) |
| Enumeration Date | 2020-11-15 |
| Last Update Date | 2021-06-15 |