| NPI | 1164214102 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 10284775-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 10284775-4405) |
| Enumeration Date | 2025-05-17 |
| Last Update Date | 2025-11-24 |