| NPI | 1972292654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NY 352154) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1114292) |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-06-14 |