| NPI | 1700252780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP129790) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY F339681) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2020-06-22 |