| NPI | 1205439379 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1019043) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NY 799040) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2024-01-02 |