| NPI | 1861978389 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1003937) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 884687) |
| Enumeration Date | 2018-07-17 |
| Last Update Date | 2022-01-11 |