| NPI | 1194141861 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 23392) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 5016025) | 
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 742276) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: NC 5016025) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP124737) | |
| Enumeration Date | 2014-03-05 | 
| Last Update Date | 2023-01-10 |