| NPI | 1992242911 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 201702146NP) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP132606) |
| Enumeration Date | 2017-01-28 |
| Last Update Date | 2020-12-03 |