| NPI | 1982472106 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: LA 245509) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2024046924) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1143501) | |
| Enumeration Date | 2023-12-18 |
| Last Update Date | 2026-04-07 |