| NPI | 1578262556 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1111836) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1111836) |
| 363L00000X Nurse Practitioner (Licence: TX 1111836) | |
| Enumeration Date | 2023-02-28 |
| Last Update Date | 2023-08-02 |