| NPI | 1902349848 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09035)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP134054)  | 
| 363L00000X Nurse Practitioner (Licence: LA AP09035)  | |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 09035)  | |
| Enumeration Date | 2016-11-27 | 
| Last Update Date | 2023-03-21 |