| NPI | 1730803073 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1093967) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1093967) |
| Enumeration Date | 2022-09-29 |
| Last Update Date | 2022-12-20 |