| NPI | 1730653122 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MD R246127) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP140228) |
| 363LF0000X Nurse Practitioner, Family (Licence: AZ 256499) | |
| Enumeration Date | 2019-01-18 |
| Last Update Date | 2021-09-22 |