| NPI | 1316539703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1011010) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: PA SP021633) |
| Enumeration Date | 2021-02-07 |
| Last Update Date | 2021-02-07 |