| NPI | 1316677495 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1008906) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: CA 95021080) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |