| NPI | 1699174102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP126264) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126264) |
| 363L00000X Nurse Practitioner (Licence: TX AP126264) | |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2020-02-11 |