| NPI | 1619365988 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP131847) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 19523) |
| Enumeration Date | 2015-01-08 |
| Last Update Date | 2023-07-15 |