| NPI | 1992306609 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 30217) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1003083) |
| Enumeration Date | 2020-11-08 |
| Last Update Date | 2021-10-06 |