| NPI | 1063170066 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1060344) |
| Additional Taxonomies | 207QA0000X Family Medicine Adolescent Medicine (Licence: TX 1060344) |
| 207QA0505X Family Medicine Adult Medicine (Licence: TX 1060344) | |
| 207QH0002X Family Medicine Hospice and Palliative Medicine (Licence: TX 1060344) | |
| 207VM0101X Obstetrics & Gynecology Maternal & Fetal Medicine (Licence: TX 1060344) | |
| Enumeration Date | 2021-12-07 |
| Last Update Date | 2021-12-07 |