| NPI | 1528639200 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 64342) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1048023) |
| Enumeration Date | 2021-07-05 |
| Last Update Date | 2024-09-18 |