| NPI | 1114449576 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 10818561-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: PA SP017639) |
| Enumeration Date | 2017-07-07 |
| Last Update Date | 2024-01-31 |