| NPI | 1073512810 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA VP003650C) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP126300) |
| Enumeration Date | 2005-07-14 |
| Last Update Date | 2023-02-01 |