| NPI | 1457928459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10385727-4405)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 103857273102)  | 
| Enumeration Date | 2021-06-08 | 
| Last Update Date | 2022-12-11 |