| NPI | 1568007961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 787791) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 787791) |
| Enumeration Date | 2019-11-10 |
| Last Update Date | 2020-06-24 |