| NPI | 1962245167 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1166995) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1166995) |
| Enumeration Date | 2024-06-15 |
| Last Update Date | 2024-09-20 |