| NPI | 1053021493 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11035674) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1179558) |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2024-11-06 |