| NPI | 1083083026 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 8873) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 880336) |
| 363L00000X Nurse Practitioner (Licence: TX AP128693) | |
| Enumeration Date | 2015-09-21 |
| Last Update Date | 2020-10-01 |