| NPI | 1861932253 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 10016612) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: KY 3011157) |
| 363LP2300X Nurse Practitioner Primary Care (Licence: KY 3011157) | |
| Enumeration Date | 2017-03-03 |
| Last Update Date | 2021-01-25 |