| NPI | 1245989961 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 68850) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1068123) |
| Enumeration Date | 2022-03-21 |
| Last Update Date | 2022-09-27 |