| NPI | 1639792484 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP145851) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 776379) |
| Enumeration Date | 2020-05-27 |
| Last Update Date | 2020-09-18 |