| NPI | 1902347040 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: CO Ap133150) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP133150) | 
| Enumeration Date | 2017-03-08 | 
| Last Update Date | 2021-04-07 |