| NPI | 1124629910 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5013844) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 913350) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1008167) | |
| Enumeration Date | 2020-11-06 |
| Last Update Date | 2021-02-16 |