| NPI | 1396352001 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 4951873-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 4951873-3102) |
| Enumeration Date | 2020-09-26 |
| Last Update Date | 2020-12-03 |