| NPI | 1780220418 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11004996) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1070791) |
| Enumeration Date | 2019-11-18 |
| Last Update Date | 2024-02-11 |