| NPI | 1316352339 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: AZ AP8811) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP125866) |
| 363L00000X Nurse Practitioner (Licence: TX 662611) | |
| 363L00000X Nurse Practitioner (Licence: AZ MSL662611TX) | |
| Enumeration Date | 2014-06-27 |
| Last Update Date | 2020-09-08 |