| NPI | 1306309117 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: ID 72817) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: NM 56876) |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP140458) | |
| Enumeration Date | 2019-04-09 |
| Last Update Date | 2023-02-14 |