| NPI | 1023853603 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1139715) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-83316-091) |
| Enumeration Date | 2024-06-26 |
| Last Update Date | 2025-01-14 |