| NPI | 1912448416 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP133163) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F0117566) |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2018-06-06 |