| NPI | 1295428654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5780899-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 5780899-8900) |
| Enumeration Date | 2023-05-31 |
| Last Update Date | 2023-06-13 |