| NPI | 1053905950 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024187091) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1030644) |
| Enumeration Date | 2021-02-22 |
| Last Update Date | 2024-03-12 |