| NPI | 1609423946 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11010120) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142088) | 
| Enumeration Date | 2019-08-21 | 
| Last Update Date | 2021-06-25 |