| NPI | 1619490166 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 200506) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP134468) | 
| Enumeration Date | 2017-07-17 | 
| Last Update Date | 2019-08-20 |