| NPI | 1952142697 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 12464488-4402) |
| Additional Taxonomies | 363LS0200X Nurse Practitioner, School (Licence: UT 12464488-3102) |
| Enumeration Date | 2024-06-05 |
| Last Update Date | 2025-07-25 |