| NPI | 1972573657 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP111016) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 588516) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 588516) | |
| Enumeration Date | 2006-01-25 |
| Last Update Date | 2022-09-26 |