| NPI | 1619428026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP135197) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F339941) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 6731) | |
| Enumeration Date | 2016-10-20 |
| Last Update Date | 2019-04-30 |