| NPI | 1356092423 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1072453) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 822432) |
| Enumeration Date | 2022-01-11 |
| Last Update Date | 2022-10-26 |