| NPI | 1821711169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: CA 95013358) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1119112) |
| 363L00000X Nurse Practitioner (Licence: OK 211096) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CA 95013358) | |
| Enumeration Date | 2022-09-21 |
| Last Update Date | 2024-02-29 |