| NPI | 1316652621 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: IA A172673) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CT 1316652621) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1226022) | |
| Enumeration Date | 2023-01-20 |
| Last Update Date | 2026-02-05 |