| NPI | 1780253179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1048573) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX student) |
| Enumeration Date | 2021-06-21 |
| Last Update Date | 2023-05-15 |