| NPI | 1790245330 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 60781) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TX 673736) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP141130) | |
| Enumeration Date | 2019-03-20 |
| Last Update Date | 2020-10-12 |