| NPI | 1174081756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP140758) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP140758) |
| Enumeration Date | 2019-03-04 |
| Last Update Date | 2020-04-07 |