| NPI | 1972242980 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1086280) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F10210144) |
| Enumeration Date | 2022-05-31 |
| Last Update Date | 2022-06-29 |