| NPI | 1912383498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5530782-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID NP-1613A) |
| Enumeration Date | 2015-08-06 |
| Last Update Date | 2026-03-13 |