| NPI | 1558456152 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1020694) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023036512) |
| 363LF0000X Nurse Practitioner, Family (Licence: PA SP007668) | |
| Enumeration Date | 2006-10-03 |
| Last Update Date | 2023-09-08 |