| NPI | 1245799840 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1058643) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 309063) |
| Enumeration Date | 2019-03-14 |
| Last Update Date | 2022-08-26 |