| NPI | 1912612375 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 9902215-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 9902215-4405) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2024-11-20 |