| NPI | 1063185668 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1048576) |
| Additional Taxonomies | 163WW0000X Registered Nurse, Wound Care (Licence: TX 781170) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1048576) | |
| Enumeration Date | 2021-07-29 |
| Last Update Date | 2024-03-25 |