| NPI | 1659199057 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1012749) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA GAA-NP002754) |
| 363L00000X Nurse Practitioner (Licence: TX 1012749) | |
| Enumeration Date | 2024-10-03 |
| Last Update Date | 2025-08-07 |