| NPI | 1164703328 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 369162-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 369162-4408) |
| Enumeration Date | 2011-09-01 |
| Last Update Date | 2022-07-21 |