| NPI | 1982247094 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142642) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 809564) |
| Enumeration Date | 2019-10-21 |
| Last Update Date | 2019-10-21 |