| NPI | 1669044624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10496639-4405) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: UT 10496639-3102) |
| Enumeration Date | 2021-07-10 |
| Last Update Date | 2025-04-18 |