| NPI | 1598457541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11948214-3102) |
| Additional Taxonomies | 163WC1400X Registered Nurse, College Health (Licence: UT 11948214-3102) |
| Enumeration Date | 2023-05-25 |
| Last Update Date | 2024-10-15 |