| NPI | 1104536796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1158233) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: PA SP027158) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2024-07-02 |