| NPI | 1083113534 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX AP136952) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX F01181090) |
| Enumeration Date | 2018-02-09 |
| Last Update Date | 2022-05-22 |