| NPI | 1215691076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 375582-4405) |
| Additional Taxonomies | 163WN0002X Registered Nurse, Neonatal Intensive Care (Licence: UT 375582-3102) |
| Enumeration Date | 2021-10-27 |
| Last Update Date | 2022-03-17 |