| NPI | 1609632942 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 5020080) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: FL APRN11031477) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 1156726) | |
| Enumeration Date | 2024-02-23 |
| Last Update Date | 2024-06-08 |