| NPI | 1720519895 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5354987-3102) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 5354984-4405) |
| Enumeration Date | 2017-03-21 |
| Last Update Date | 2021-02-04 |