| NPI | 1437634904 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MO 2018031646) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138078) | 
| Enumeration Date | 2018-10-01 | 
| Last Update Date | 2020-11-11 |