| NPI | 1255845921 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 9415866) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1146156) |
| Enumeration Date | 2017-11-16 |
| Last Update Date | 2024-12-31 |