| NPI | 1932558541 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 11127070-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AK 111813) |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 99538) | |
| Enumeration Date | 2016-06-06 |
| Last Update Date | 2022-04-25 |