| NPI | 1861976995 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX F09181392) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 908983) |
| Enumeration Date | 2018-09-25 |
| Last Update Date | 2018-11-24 |