| NPI | 1104075092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 4946810-4405) |
| Additional Taxonomies | 284300000X Special Hospital (Licence: UT 4946810-4405) |
| 363LF0000X Nurse Practitioner, Family (Licence: UT 4946810-4405) | |
| Enumeration Date | 2008-09-16 |
| Last Update Date | 2023-08-09 |