| NPI | 1871364760 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 7677239-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7677239-3102) |
| Enumeration Date | 2024-01-10 |
| Last Update Date | 2025-02-05 |