| NPI | 1952063547 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1046567) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046567) |
| Enumeration Date | 2021-10-11 |
| Last Update Date | 2022-01-13 |