| NPI | 1639667884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F10231149) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 872790) |
| Enumeration Date | 2018-04-24 |
| Last Update Date | 2024-01-25 |