| NPI | 1881265767 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MN 12030) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1045880) |
| Enumeration Date | 2021-07-01 |
| Last Update Date | 2024-12-05 |