| NPI | 1255705422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ 248664) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1024900) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: PA SP015542) | |
| Enumeration Date | 2015-11-25 |
| Last Update Date | 2024-04-22 |