| NPI | 1922681444 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LS0200X Nurse Practitioner, School (Licence: UT 10144774-3102)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 10144774-3102)  | 
| Enumeration Date | 2021-05-03 | 
| Last Update Date | 2021-05-03 |