| NPI | 1861038507 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1038890) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 936782) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2021-05-17 |