| NPI | 1710631338 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3017007) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1069552) |
| Enumeration Date | 2022-02-11 |
| Last Update Date | 2022-11-30 |