| NPI | 1376189696 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 24181381) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 965737) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP141622) | |
| Enumeration Date | 2019-11-21 |
| Last Update Date | 2023-11-14 |