| NPI | 1114513843 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1008178) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2378046) |
| Enumeration Date | 2020-12-16 |
| Last Update Date | 2024-12-24 |