| NPI | 1386382612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 6854176-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 6854176-4405) |
| 163W00000X Registered Nurse (Licence: UT 6854176-3102) | |
| Enumeration Date | 2022-05-25 |
| Last Update Date | 2026-06-23 |