| NPI | 1700540317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1057767) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1057767) |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-12-07 |