| NPI | 1740866102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 63708) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1033097) |
| Enumeration Date | 2021-03-24 |
| Last Update Date | 2021-12-26 |