| NPI | 1912752627 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: WY 54193) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 965544) |
| Enumeration Date | 2024-04-17 |
| Last Update Date | 2024-04-19 |