| NPI | 1255927612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 10399744-4405) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: UT 103997444405) |
| Enumeration Date | 2020-12-18 |
| Last Update Date | 2022-03-09 |