| NPI | 1235764135 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1075619) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024179000) |
| Enumeration Date | 2020-03-11 |
| Last Update Date | 2023-02-14 |