| NPI | 1699463984 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9079298-4405)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 9079298-4405)  | 
| 163WP2201X Registered Nurse, Ambulatory Care (Licence: UT 9079298-3102)  | |
| Enumeration Date | 2023-04-26 | 
| Last Update Date | 2024-12-08 |