| NPI | 1215597786 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5406104-4405) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 5406104-4405) |
| 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 5406104-4405) | |
| Enumeration Date | 2019-06-17 |
| Last Update Date | 2019-06-17 |