| NPI | 1558146100 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1159388) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-82395-072) |
| Enumeration Date | 2023-08-30 |
| Last Update Date | 2024-05-29 |