| NPI | 1194372078 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX AP138247) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NY 345306) |
| 363LF0000X Nurse Practitioner Family (Licence: NJ 26NJ00912100) | |
| Enumeration Date | 2019-08-24 |
| Last Update Date | 2022-03-25 |