| NPI | 1245836360 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1030804) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 901225) |
| Enumeration Date | 2020-12-06 |
| Last Update Date | 2021-09-02 |