| NPI | 1912543208 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142715) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP142715) |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2022-01-23 |