| NPI | 1194249763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1013902) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: GA RN270565) |
| Enumeration Date | 2017-07-26 |
| Last Update Date | 2020-11-05 |