| NPI | 1790428241 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5508759-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 5508759-8900) |
| Enumeration Date | 2022-04-13 |
| Last Update Date | 2023-02-07 |