| NPI | 1114322237 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 228255) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 627148) |
| Enumeration Date | 2014-10-31 |
| Last Update Date | 2020-09-30 |