| NPI | 1679043574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 38210) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: WA AP60990006) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP139724) | |
| Enumeration Date | 2018-12-04 |
| Last Update Date | 2025-03-14 |