| NPI | 1679176796 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9018044-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 9018044-8900) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2020-11-19 |