| NPI | 1659021392 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9415532-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 9415532-3102) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 9415532-8900) | |
| Enumeration Date | 2022-03-25 |
| Last Update Date | 2023-01-03 |