| NPI | 1740754076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP139088) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 878961) |
| Enumeration Date | 2019-01-21 |
| Last Update Date | 2019-01-21 |