| NPI | 1629676044 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NE 113720) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AP142984) |
| Enumeration Date | 2020-10-16 |
| Last Update Date | 2022-09-07 |