| NPI | 1760744783 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 07544) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 765912) |
| Enumeration Date | 2012-06-14 |
| Last Update Date | 2022-06-03 |