| NPI | 1255374153 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP126392) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IL 209005773) |
| Enumeration Date | 2006-06-14 |
| Last Update Date | 2024-07-12 |