| NPI | 1275202905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1030048) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: NY 310160) |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2021-09-07 |