| NPI | 1194170860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 75737603-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 7537603-4405) |
| Enumeration Date | 2016-04-29 |
| Last Update Date | 2021-06-09 |