| NPI | 1194376624 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1008679) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 841553) |
| Enumeration Date | 2019-09-25 |
| Last Update Date | 2021-06-08 |