| NPI | 1205887205 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 846819) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: WI 119713-030) |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209010913) | |
| Enumeration Date | 2006-05-14 |
| Last Update Date | 2024-03-28 |