| NPI | 1699592600 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 11753465-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 11753465-4405) |
| Enumeration Date | 2024-09-21 |
| Last Update Date | 2025-03-19 |