| NPI | 1982379707 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: MT 177180) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1048106) |
| Enumeration Date | 2021-08-13 |
| Last Update Date | 2022-01-05 |