| NPI | 1306584065 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 198999-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 19899-4405) |
| Enumeration Date | 2022-05-23 |
| Last Update Date | 2022-09-01 |