| NPI | 1104113299 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 844043) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY F305710) |
| Enumeration Date | 2011-07-08 |
| Last Update Date | 2020-02-04 |