| NPI | 1558109504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7992533-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 7992533-4405) |
| Enumeration Date | 2024-07-15 |
| Last Update Date | 2025-02-28 |