| NPI | 1124084355 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 12010) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 612124) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WI 12010) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2023-04-04 |