| NPI | 1649853540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1034567) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN apn0000028507) |
| Enumeration Date | 2021-04-29 |
| Last Update Date | 2021-04-29 |