| NPI | 1043870702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 6556824-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6556824-4405) |
| Enumeration Date | 2019-06-15 |
| Last Update Date | 2019-08-07 |