| NPI | 1346610466 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10436554-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: MD T20150972) |
| Enumeration Date | 2015-10-01 |
| Last Update Date | 2022-10-20 |