| NPI | 1699384792 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1014962) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 832388) | 
| Enumeration Date | 2020-07-24 | 
| Last Update Date | 2020-09-27 |