| NPI | 1649828724 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 209440) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 686490) |
| Enumeration Date | 2019-08-31 |
| Last Update Date | 2023-01-06 |