| NPI | 1790120673 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A096779) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 601322) |
| Enumeration Date | 2013-05-06 |
| Last Update Date | 2021-09-03 |