| NPI | 1477087575 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1086576) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IN 71007233A) | 
| Enumeration Date | 2017-04-14 | 
| Last Update Date | 2022-09-15 |