| NPI | 1124678495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: VA 0024178923) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1152392) |
| Enumeration Date | 2019-09-18 |
| Last Update Date | 2024-12-03 |