| NPI | 1932501624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12040121-8900) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2014034218) |
| Enumeration Date | 2014-09-24 |
| Last Update Date | 2025-07-30 |