| NPI | 1922782200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1114971) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX 1114971) |
| Enumeration Date | 2023-06-14 |
| Last Update Date | 2024-11-16 |