| NPI | 1407452642 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1064079) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 893992) |
| Enumeration Date | 2020-12-10 |
| Last Update Date | 2022-10-04 |