| NPI | 1609388669 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1041543) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP018025) |
| Enumeration Date | 2017-10-31 |
| Last Update Date | 2022-02-22 |