| NPI | 1730918574 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11596976-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: UT 11596976-4405) |
| Enumeration Date | 2024-07-30 |
| Last Update Date | 2024-09-26 |