| NPI | 1780742734 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP139921) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: TX 513134) |
| Enumeration Date | 2006-12-04 |
| Last Update Date | 2021-05-06 |