| NPI | 1053890525 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 41302) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024176470) |
| Enumeration Date | 2018-08-07 |
| Last Update Date | 2024-07-08 |