| NPI | 1821693607 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 816788) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1029020) |
| Enumeration Date | 2020-12-01 |
| Last Update Date | 2021-06-08 |