| NPI | 1578037172 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: MS 903852) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX AP140103) |
| Enumeration Date | 2019-01-16 |
| Last Update Date | 2020-05-05 |