| NPI | 1265852743 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5651985-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 5651985-4405) |
| Enumeration Date | 2014-04-23 |
| Last Update Date | 2022-02-10 |