| NPI | 1821649872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP144984) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 702866) |
| Enumeration Date | 2019-09-21 |
| Last Update Date | 2020-02-10 |