| 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 |