| NPI | 1649622770 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX F0616974) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 813349) |
| Enumeration Date | 2016-07-13 |
| Last Update Date | 2016-07-13 |