| NPI | 1982084414 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1096908) |
| Additional Taxonomies | 2255A2300X Specialist/Technologist, Athletic Trainer |
| 163WG0100X Registered Nurse, Gastroenterology (Licence: TX 1096908) | |
| Enumeration Date | 2015-05-29 |
| Last Update Date | 2023-01-26 |