| NPI | 1912465089 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: VA 0017145812) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP141998) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2021-04-13 |