| NPI | 1194430579 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1107103) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1107103) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-06-23 |