| NPI | 1720710478 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9268307-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 9268307-4405) |
| Enumeration Date | 2022-06-29 |
| Last Update Date | 2022-09-19 |