| NPI | 1710595913 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1003359) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX F06201664) |
| Enumeration Date | 2020-07-14 |
| Last Update Date | 2023-03-28 |