| NPI | 1164474813 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 634927) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: MA 267149) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2024-01-04 |