| NPI | 1164905170 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP139448) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 862607) |
| Enumeration Date | 2018-09-14 |
| Last Update Date | 2018-12-05 |