| NPI | 1407313703 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NC 5011506) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1019458) |
| Enumeration Date | 2019-02-23 |
| Last Update Date | 2022-08-17 |