| NPI | 1003213901 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 11193762-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP013990) |
| Enumeration Date | 2014-11-21 |
| Last Update Date | 2020-03-26 |