| NPI | 1992415582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1103509) |
| Additional Taxonomies | 163WG0000X Registered Nurse General Practice (Licence: UT 903087) |
| Enumeration Date | 2022-12-05 |
| Last Update Date | 2024-02-02 |