| NPI | 1225657117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8746490-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 87464904405) |
| Enumeration Date | 2020-04-11 |
| Last Update Date | 2022-02-25 |