| NPI | 1659064582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 7958015-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7858015-3102) |
| Enumeration Date | 2023-05-26 |
| Last Update Date | 2024-10-11 |