| NPI | 1497774525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 218532-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 218532-4405) |
| 363L00000X Nurse Practitioner (Licence: UT 218532-4405) | |
| Enumeration Date | 2006-07-19 |
| Last Update Date | 2025-01-22 |