| NPI | 1790223741 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP137665) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN244054) |
| 363L00000X Nurse Practitioner (Licence: TX AP137665) | |
| Enumeration Date | 2017-02-09 |
| Last Update Date | 2020-03-03 |