| NPI | 1033456744 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KS 53-78624) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP123115) |
| Enumeration Date | 2013-01-15 |
| Last Update Date | 2021-08-24 |