| NPI | 1265111207 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: LA 231111) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1128686) |
| Enumeration Date | 2023-07-17 |
| Last Update Date | 2023-07-20 |