| NPI | 1730594912 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP125741) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 709043) |
| Enumeration Date | 2014-06-25 |
| Last Update Date | 2020-09-23 |