| NPI | 1053090381 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9051741-4405) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: MT NUR-APRN-LIC-218070) |
| Enumeration Date | 2023-07-13 |
| Last Update Date | 2023-08-16 |