| NPI | 1831619014 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP134582) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 842702) |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP134582) | |
| Enumeration Date | 2017-06-20 |
| Last Update Date | 2020-06-09 |