| NPI | 1972165090 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 206539) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP142343) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP142343) | |
| 363LF0000X Nurse Practitioner, Family (Licence: LA 206539) | |
| Enumeration Date | 2019-06-29 |
| Last Update Date | 2023-01-10 |