| NPI | 1609450048 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1047239) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: MO 2021013564) |
| Enumeration Date | 2021-05-11 |
| Last Update Date | 2024-09-25 |