| NPI | 1992251268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: UT 5180478-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: UT 5180478-8900) |
| Enumeration Date | 2016-08-28 |
| Last Update Date | 2023-03-02 |