| NPI | 1952821753 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 3098529-4405) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 3098529-4405) | 
| Enumeration Date | 2017-06-22 | 
| Last Update Date | 2025-02-06 |