| NPI | 1912642075 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1072483) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1072483) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1072483) | |
| Enumeration Date | 2022-05-03 |
| Last Update Date | 2023-10-25 |