| NPI | 1346894177 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1056982) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 970511) |
| Enumeration Date | 2019-07-30 |
| Last Update Date | 2021-10-19 |