| NPI | 1578178430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1011624) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 865562) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2023-07-10 |