| NPI | 1902574676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8281304-4405) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 8281304-4405) |
| 208600000X Surgery (Licence: UT 8281304-4405) | |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |