| NPI | 1508467515 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1010243) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 791906) |
| Enumeration Date | 2020-11-05 |
| Last Update Date | 2021-10-05 |