| NPI | 1972256667 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1068390) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1068390) |
| 363L00000X Nurse Practitioner (Licence: TX 1068390) | |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2023-04-24 |