| NPI | 1902588759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1159166) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: LA 232006) |
| 363LF0000X Nurse Practitioner Family (Licence: LA 129353) | |
| Enumeration Date | 2023-08-02 |
| Last Update Date | 2024-08-01 |