| NPI | 1245837251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1015504) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA Pending) |
| Enumeration Date | 2020-10-02 |
| Last Update Date | 2021-06-23 |