| NPI | 1609556992 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1175919) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner Primary Care (Licence: IA A174066) |
| Enumeration Date | 2023-07-20 |
| Last Update Date | 2024-10-08 |