| NPI | 1063091544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 13470783-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95022743) |
| Enumeration Date | 2021-04-03 |
| Last Update Date | 2024-05-06 |