| NPI | 1619332756 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1007546) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP015787) |
| Enumeration Date | 2015-12-16 |
| Last Update Date | 2022-09-21 |