| NPI | 1720584147 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 8340881-4405) |
| Additional Taxonomies | 163WG0000X Registered Nurse, General Practice (Licence: UT 8340881-3102) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-07-03 |