| NPI | 1124670872 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8010164-4405) |
| Additional Taxonomies | 163WM0705X Registered Nurse, Medical-Surgical (Licence: UT 8010164-3102) |
| Enumeration Date | 2019-07-12 |
| Last Update Date | 2021-02-10 |