| NPI | 1750041976 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12480251-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 53252) |
| Enumeration Date | 2021-12-29 |
| Last Update Date | 2023-01-08 |