| NPI | 1609416650 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1022185) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: FL 11005653) |
| Enumeration Date | 2020-01-07 |
| Last Update Date | 2024-09-23 |