| NPI | 1124640792 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 345860) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP144736) |
| Enumeration Date | 2020-05-17 |
| Last Update Date | 2025-01-10 |