| NPI | 1639803588 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1076024) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 68179) |
| Enumeration Date | 2022-07-14 |
| Last Update Date | 2022-07-14 |