| NPI | 1639787872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1130715) |
| Additional Taxonomies | 171000000X Military Health Care Provider |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2024-09-16 |