| NPI | 1265085138 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142172) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP142172) | 
| Enumeration Date | 2019-07-19 | 
| Last Update Date | 2021-03-17 |