| NPI | 1164066262 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 2024014170) |
| Additional Taxonomies | 164W00000X Licensed Practical Nurse (Licence: UT 11297752-3101) |
| Enumeration Date | 2019-10-31 |
| Last Update Date | 2024-06-02 |