| NPI | 1295484954 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-203778) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1071246) | 
| Enumeration Date | 2022-03-21 | 
| Last Update Date | 2025-06-04 |