| NPI | 1629620687 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 164W00000X Licensed Practical Nurse (Licence: TX 832125) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX Ap140137) |
| Enumeration Date | 2019-07-10 |
| Last Update Date | 2019-07-11 |