| NPI | 1952931263 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1015629) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 872815) |
| Enumeration Date | 2020-01-26 |
| Last Update Date | 2020-10-01 |