| NPI | 1194339762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 3-000790) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 763852) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1015367) | |
| Enumeration Date | 2020-09-01 |
| Last Update Date | 2022-11-07 |