| NPI | 1518508282 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1017686) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: LA F06192640) |
| Enumeration Date | 2019-10-03 |
| Last Update Date | 2021-12-15 |