| NPI | 1629776430 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NM 72528) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1111103) |
| Enumeration Date | 2023-02-21 |
| Last Update Date | 2023-05-19 |