| NPI | 1962042598 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 55874) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141655) |
| Enumeration Date | 2020-01-11 |
| Last Update Date | 2025-01-16 |