| 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 |