| NPI | 1114389939 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 9294977) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1043629) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA 164460) | |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 260382) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 61513) | |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2021-11-16 |