| NPI | 1760915664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP142305) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: WI 7609-33) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2020-03-09 |