| NPI | 1295327054 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 335648-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 335648-3102) |
| Enumeration Date | 2021-02-03 |
| Last Update Date | 2021-08-31 |