| NPI | 1912537234 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1012454) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 860248) |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2020-12-08 |