| NPI | 1982254025 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 835148) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1012941) |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2021-06-15 |