| NPI | 1679824130 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 121619) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 662664) |
| Enumeration Date | 2012-09-25 |
| Last Update Date | 2023-08-25 |