| NPI | 1790459618 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1124675) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WV 110284) |
| Enumeration Date | 2021-08-04 |
| Last Update Date | 2023-08-17 |