| NPI | 1962088732 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 353760-4405) |
| Additional Taxonomies | 283X00000X Rehabilitation Hospital |
| Enumeration Date | 2021-03-22 |
| Last Update Date | 2024-08-12 |