| NPI | 1053070730 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1000599) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: TX 1000599) |
| Enumeration Date | 2021-12-10 |
| Last Update Date | 2024-05-14 |