| NPI | 1124638812 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8049068-4405) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 8049068-4405) |
| Enumeration Date | 2020-08-06 |
| Last Update Date | 2021-11-08 |