| NPI | 1407656093 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12032331-4405) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 12032331-4405) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 12032331-4405) | |
| Enumeration Date | 2025-03-14 |
| Last Update Date | 2025-04-02 |