| NPI | 1215596192 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 7734927-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 7734927-8900) |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2020-07-07 |