| NPI | 1770056822 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP140123) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 708743) |
| Enumeration Date | 2019-01-10 |
| Last Update Date | 2024-06-27 |