| NPI | 1215512819 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: TX 1030524) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX 1030524) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1030524) | |
| Enumeration Date | 2021-03-15 |
| Last Update Date | 2022-05-23 |