| NPI | 1669814117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7310211-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 73102118900) |
| Enumeration Date | 2013-07-25 |
| Last Update Date | 2021-12-15 |