| NPI | 1073120762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP1097801) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 944960) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP1097801) | |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2023-05-04 |