| NPI | 1114509734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F07210372) |
| Additional Taxonomies | 163WP0200X Registered Nurse, Pediatrics (Licence: TX 922155) |
| 363L00000X Nurse Practitioner (Licence: TX 1076808) | |
| Enumeration Date | 2021-04-23 |
| Last Update Date | 2022-06-03 |