| NPI | 1063517688 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 775004) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP118253) |
| 363L00000X Nurse Practitioner (Licence: KS 45221) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2023-09-08 |