| NPI | 1376545251 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 1835254405) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: UT 1835254405) |
| Enumeration Date | 2005-08-11 |
| Last Update Date | 2024-04-30 |