| NPI | 1366008922 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6115251-4408) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 6115251-3102) |
| Enumeration Date | 2019-05-18 |
| Last Update Date | 2019-05-18 |