| NPI | 1114698644 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 75117) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1046020) |
| Enumeration Date | 2021-09-23 |
| Last Update Date | 2023-11-25 |