| NPI | 1023823044 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 14204321-4405) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 259925) | 
| Enumeration Date | 2025-02-07 | 
| Last Update Date | 2025-02-12 |