| NPI | 1902605397 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 9029128-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 9029128-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 9029128-8900) | |
| Enumeration Date | 2025-03-10 |
| Last Update Date | 2025-05-08 |