| NPI | 1023614377 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1016725) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: OR 202203080NP-PP) |
| 363L00000X Nurse Practitioner (Licence: AZ 303999) | |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2024-05-16 |