| NPI | 1497768279 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: UT 215559-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 215559-4405) |
| Enumeration Date | 2006-08-14 |
| Last Update Date | 2021-12-20 |