| NPI | 1619452455 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1055555) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MN 6215) |
| 363LF0000X Nurse Practitioner, Family (Licence: MN 2015174) | |
| Enumeration Date | 2018-09-27 |
| Last Update Date | 2023-06-02 |