| NPI | 1942897087 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1030488) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 251373) |
| Enumeration Date | 2020-12-23 |
| Last Update Date | 2022-12-08 |