| NPI | 1508464363 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1017289) |
| Additional Taxonomies | 207QA0000X Family Medicine, Adolescent Medicine (Licence: OK F09201316) |
| Enumeration Date | 2020-10-14 |
| Last Update Date | 2021-01-07 |