| NPI | 1578342069 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9364086-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 9364086-3102) |
| Enumeration Date | 2023-09-25 |
| Last Update Date | 2023-11-15 |