| NPI | 1790388932 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1041046) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 856222) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2021-06-09 |