| NPI | 1114469038 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 10500172) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: VA 0017142938) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2023-08-08 |