| NPI | 1477377828 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 14153131-4405)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 14153131-8900)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: IA A181342)  | |
| Enumeration Date | 2024-11-12 | 
| Last Update Date | 2024-11-12 |