| NPI | 1821572868 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TN 24084) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP137931) |
| Enumeration Date | 2018-09-15 |
| Last Update Date | 2018-09-15 |