| NPI | 1174215032 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1097377) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3018874) |
| 363LF0000X Nurse Practitioner Family (Licence: TN 0000031018) | |
| Enumeration Date | 2023-05-22 |
| Last Update Date | 2023-07-13 |