| NPI | 1346874997 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1045841) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024178810) |
| Enumeration Date | 2020-02-22 |
| Last Update Date | 2021-09-10 |