| NPI | 1669443537 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 6293) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024158853) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 753648) | |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2020-12-04 |