| NPI | 1689236077 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: OR 10024300-APRN)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP141935)  | 
| 363L00000X Nurse Practitioner (Licence: NH 092344-23)  | |
| Enumeration Date | 2019-07-05 | 
| Last Update Date | 2024-06-13 |