| NPI | 1659156917 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11778064-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 11778064-3102) |
| Enumeration Date | 2023-08-25 |
| Last Update Date | 2026-05-01 |