| NPI | 1962741520 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP122936) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 647619) |
| Enumeration Date | 2013-02-01 |
| Last Update Date | 2023-10-20 |