| NPI | 1083353643 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT F02220852) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 74993) |
| Enumeration Date | 2022-06-01 |
| Last Update Date | 2023-07-20 |