| NPI | 1740839844 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5323808-8900) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 5323808-3102) |
| Enumeration Date | 2019-09-11 |
| Last Update Date | 2022-03-14 |