| NPI | 1770298309 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT F06240096) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 4901790-3102) |
| Enumeration Date | 2023-01-18 |
| Last Update Date | 2024-06-03 |