| NPI | 1124727805 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1128182) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 828671) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2023-08-11 |