| NPI | 1679154397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1031866) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 913739) |
| Enumeration Date | 2021-04-15 |
| Last Update Date | 2021-10-06 |