| NPI | 1104294875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1030527) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 6586-33) |
| Enumeration Date | 2015-09-10 |
| Last Update Date | 2024-10-09 |