| NPI | 1487010393 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WI 14464-33) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP131979) | 
| Enumeration Date | 2016-01-07 | 
| Last Update Date | 2024-05-23 |