| NPI | 1912403676 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5015429) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136033) |
| 363LF0000X Nurse Practitioner, Family (Licence: IA A166587) | |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2022-09-29 |