| NPI | 1790395531 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1112632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 245540) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2024-08-01 |