| NPI | 1225683915 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 53393) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 222953) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP145032) | |
| Enumeration Date | 2019-08-08 |
| Last Update Date | 2024-02-21 |