| NPI | 1063133544 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: FL 11021703) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2025034516) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1212142) | |
| Enumeration Date | 2022-09-05 |
| Last Update Date | 2026-03-10 |