| NPI | 1245696772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: MS 905033) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129588) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP08551) | |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2022-02-07 |