| NPI | 1003865551 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM 03560) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 29229) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX ap116450) | |
| 363LF0000X Nurse Practitioner, Family (Licence: NY 334373) | |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2023-12-01 |