| NPI | 1912529686 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner Primary Care (Licence: TX 1129667) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 989518) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2023-07-26 |