| NPI | 1093189300 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5012672) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL ARNP9267516) |
| 207Q00000X Family Medicine (Licence: NC 5012672) | |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP145166) | |
| Enumeration Date | 2015-11-24 |
| Last Update Date | 2023-02-21 |