| NPI | 1023492410 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 78591) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128436) |
| Enumeration Date | 2015-07-15 |
| Last Update Date | 2022-01-22 |