| NPI | 1730582123 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0017142594) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126054) |
| Enumeration Date | 2014-09-30 |
| Last Update Date | 2019-02-20 |