| NPI | 1912171497 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP119325) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP009791) |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-09-16 |