| NPI | 1912503681 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1031765) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 979955) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2021-04-15 |