| NPI | 1730654526 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 109942204405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 10994220-4405) |
| Enumeration Date | 2018-10-08 |
| Last Update Date | 2019-03-15 |