| NPI | 1558110395 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 11932174-3102) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 11932174-3102) |
| Enumeration Date | 2024-05-14 |
| Last Update Date | 2025-05-22 |