| NPI | 1639636947 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140739) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 854154) |
| Enumeration Date | 2019-02-22 |
| Last Update Date | 2019-06-18 |