| NPI | 1073094702 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 7849026-4405) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 78490263102) |
| Enumeration Date | 2018-08-21 |
| Last Update Date | 2023-11-27 |