| NPI | 1255617007 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: LA 226256) |
| Additional Taxonomies | 163WR0006X Registered Nurse Registered Nurse First Assistant (Licence: TX 569299) |
| 363L00000X Nurse Practitioner (Licence: TX AP130610) | |
| Enumeration Date | 2011-10-25 |
| Last Update Date | 2024-03-21 |