| NPI | 1013567759 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WA 61376318) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 887299) |
| 363L00000X Nurse Practitioner (Licence: MT NUR-APRN-LIC-160065) | |
| Enumeration Date | 2019-09-15 |
| Last Update Date | 2024-08-13 |