| NPI | 1790388015 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 1016446) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1016446) |
| Enumeration Date | 2020-11-19 |
| Last Update Date | 2022-11-17 |