| NPI | 1043907710 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 9062330-3102) |
| Additional Taxonomies | 163WR0400X Registered Nurse, Rehabilitation (Licence: UT 9062330-3102) |
| Enumeration Date | 2023-04-21 |
| Last Update Date | 2023-08-25 |