| NPI | 1649642901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NM 56518) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP129481) |
| Enumeration Date | 2015-10-27 |
| Last Update Date | 2019-09-16 |