| NPI | 1588190623 |
|---|---|
| Former Name | CRYSTAL BOTELLO |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP133479) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP133479) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2024-04-11 |