| NPI | 1053191569 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1142467) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TX 1142467) |
| Enumeration Date | 2023-10-02 |
| Last Update Date | 2023-12-12 |