| NPI | 1902563539 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1084148) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 818932) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX F04220448) | |
| Enumeration Date | 2021-11-18 |
| Last Update Date | 2022-12-28 |