| NPI | 1053293084 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1205701) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1205701) |
| Enumeration Date | 2025-07-22 |
| Last Update Date | 2025-08-22 |