| NPI | 1942789433 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 364302-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 277575-4405) |
| 363L00000X Nurse Practitioner (Licence: ID 59590) | |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2022-04-13 |