| NPI | 1124878830 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11842040-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 11842040-8900) |
| Enumeration Date | 2024-03-25 |
| Last Update Date | 2024-03-25 |