| NPI | 1376050591 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: VA 0024175657) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1007321) |
| Enumeration Date | 2018-01-09 |
| Last Update Date | 2023-11-04 |