| NPI | 1609480540 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 61017) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1010578) |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2026-05-07 |