| NPI | 1891461042 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1047555) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1047555) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1047555) | |
| Enumeration Date | 2021-08-18 |
| Last Update Date | 2022-09-13 |