| NPI | 1104254986 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP1010691) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KY 3008283) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: KY 3008283) | |
| 363LF0000X Nurse Practitioner, Family (Licence: KY 3008283) | |
| Enumeration Date | 2013-10-14 |
| Last Update Date | 2023-05-25 |