| NPI | 1689322141 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 10342832-4405) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 10342832-4405) | 
| Enumeration Date | 2022-03-14 | 
| Last Update Date | 2024-09-27 |