| NPI | 1679169502 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1020701) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1020701) |
| Enumeration Date | 2020-12-15 |
| Last Update Date | 2023-06-08 |