| NPI | 1164933883 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA AP09975) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA AP09975) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP1355205) | |
| Enumeration Date | 2017-10-20 | 
| Last Update Date | 2024-03-22 |