| NPI | 1053961268 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1161651) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 9623) |
| 363L00000X Nurse Practitioner (Licence: CA NP95016188) | |
| Enumeration Date | 2019-09-19 |
| Last Update Date | 2024-06-13 |