| NPI | 1902415722 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP144782) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 756163338) |
| Enumeration Date | 2020-07-28 |
| Last Update Date | 2022-05-25 |