| NPI | 1093438855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 753779-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7537729-3102) |
| Enumeration Date | 2022-09-26 |
| Last Update Date | 2023-08-24 |