| NPI | 1366197402 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5015845) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1151725) |
| 363L00000X Nurse Practitioner (Licence: SC APN.28370) | |
| Enumeration Date | 2022-02-17 |
| Last Update Date | 2025-01-24 |