| NPI | 1851972632 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F02210173) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 795501) |
| Enumeration Date | 2021-04-14 |
| Last Update Date | 2021-04-14 |