| NPI | 1336779552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1007970) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 902480) |
| Enumeration Date | 2020-01-16 |
| Last Update Date | 2020-10-01 |