| NPI | 1760255277 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9042264-8900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 9042264-4405) |
| Enumeration Date | 2023-11-06 |
| Last Update Date | 2023-11-06 |