| NPI | 1962913830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP137562) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: FL ARNP9360091) |
| Enumeration Date | 2017-10-19 |
| Last Update Date | 2018-08-23 |