| NPI | 1578246468 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12373902-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 64371) |
| Enumeration Date | 2023-08-08 |
| Last Update Date | 2026-04-16 |