| NPI | 1710381363 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 6997367-4405)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 6997367-3102)  | 
| Enumeration Date | 2014-10-10 | 
| Last Update Date | 2025-06-20 |