| NPI | 1912417858 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP135083) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX AP135083) |
| Enumeration Date | 2017-10-05 |
| Last Update Date | 2017-10-12 |