| NPI | 1174180749 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1034540) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 887035) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1034540) | |
| Enumeration Date | 2019-05-20 |
| Last Update Date | 2024-05-20 |