| NPI | 1124597117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 776675) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP140095) |
| Enumeration Date | 2018-11-19 |
| Last Update Date | 2020-10-07 |