| NPI | 1063954097 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: GA 216735) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1154231) |
| 363L00000X Nurse Practitioner (Licence: AL 3-001889) | |
| 363L00000X Nurse Practitioner (Licence: FL 11033969) | |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2024-08-14 |