| NPI | 1972860591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP121757) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OK 210390) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX A121757) | |
| Enumeration Date | 2012-04-19 |
| Last Update Date | 2023-09-25 |