| NPI | 1417507278 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7872552-4405) |
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: UT 7872552-3102) |
| Enumeration Date | 2019-09-13 |
| Last Update Date | 2019-10-10 |