| NPI | 1144983107 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12347174-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 12347174-8900) |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2024-06-02 |