| NPI | 1972069110 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1034217) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: AL 1-166711) |
| Enumeration Date | 2019-02-13 |
| Last Update Date | 2021-12-03 |