| NPI | 1235879891 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 5487196-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 54871964405) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2022-08-10 |