| NPI | 1053085050 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12359468-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 12359468-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A164279) | |
| Enumeration Date | 2021-08-03 |
| Last Update Date | 2021-12-20 |