| NPI | 1700400454 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: NC 5013146) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1099342) |
| Enumeration Date | 2020-05-28 |
| Last Update Date | 2025-10-13 |