| NPI | 1962797589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1105844) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-75376-102) |
| Enumeration Date | 2011-06-11 |
| Last Update Date | 2023-05-09 |