| NPI | 1962038661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP140989) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: GA RN209221) |
| Enumeration Date | 2020-03-14 |
| Last Update Date | 2020-03-14 |