| NPI | 1407368137 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11020226) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP135449) |
| 363L00000X Nurse Practitioner (Licence: NC 5022939) | |
| 363L00000X Nurse Practitioner (Licence: NM 53040) | |
| Enumeration Date | 2017-11-03 |
| Last Update Date | 2025-10-16 |