| NPI | 1730959990 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11115850-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 11115850-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 11115850-3102) | |
| 363LF0000X Nurse Practitioner, Family (Licence: UT F11230625) | |
| Enumeration Date | 2024-01-08 |
| Last Update Date | 2024-10-03 |