| NPI | 1215763222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 13915822-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 13915822-3102) |
| 163W00000X Registered Nurse (Licence: MA RN2308942) | |
| Enumeration Date | 2024-09-09 |
| Last Update Date | 2024-09-09 |