| NPI | 1649838111 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP140007) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140007) |
| Enumeration Date | 2019-05-30 |
| Last Update Date | 2022-01-13 |