| NPI | 1790369270 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 4920704-4405) |
| Additional Taxonomies | 163WW0101X Registered Nurse, Women's Health Care, Ambulatory (Licence: UT 4920704-3102) |
| Enumeration Date | 2021-05-10 |
| Last Update Date | 2022-02-03 |