| NPI | 1679204952 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 8484609-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 8484609-4405) |
| 163W00000X Registered Nurse (Licence: UT 8484609-3102) | |
| Enumeration Date | 2022-06-18 |
| Last Update Date | 2024-03-04 |