| NPI | 1184387417 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1171404) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WY 48194) |
| Enumeration Date | 2021-10-13 |
| Last Update Date | 2024-10-08 |