| NPI | 1053086348 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 10331826-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ID 69178) |
| 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-183916) | |
| Enumeration Date | 2021-08-10 |
| Last Update Date | 2026-03-17 |