| NPI | 1083323653 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208VP0000X (Licence: TX 1094743) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 109473) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX 1094743) | |
| Enumeration Date | 2022-11-22 |
| Last Update Date | 2023-03-08 |