| NPI | 1013174317 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 347629-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-75567-051) |
| Enumeration Date | 2008-05-22 |
| Last Update Date | 2022-12-03 |