| NPI | 1083364764 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 764096) |
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: TX 1073705) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 764096) | |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2022-08-11 |