| NPI | 1770131153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1061718) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95162159) |
| Enumeration Date | 2019-08-29 |
| Last Update Date | 2022-05-19 |