| NPI | 1750911673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MS 904432) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 27148) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 32712) | |
| Enumeration Date | 2020-01-20 |
| Last Update Date | 2022-05-26 |