| NPI | 1790462869 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 14197236-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL 11024874) |
| Enumeration Date | 2023-06-30 |
| Last Update Date | 2025-06-19 |