| NPI | 1700617990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1053811) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 268093) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2024-08-28 |