| NPI | 1306407820 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8732025-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 8732025-3102) |
| Enumeration Date | 2019-06-25 |
| Last Update Date | 2021-12-20 |