| NPI | 1659936151 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 98046634405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 98046638900) |
| Enumeration Date | 2019-05-09 |
| Last Update Date | 2019-05-09 |