| NPI | 1518242064 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP128025) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 31258) |
| 363L00000X Nurse Practitioner (Licence: AL 1-188981) | |
| 363L00000X Nurse Practitioner (Licence: IL 209025180) | |
| 363LF0000X Nurse Practitioner, Family (Licence: MN F0911484) | |
| 363LF0000X Nurse Practitioner, Family (Licence: OK 207492) | |
| Enumeration Date | 2011-10-17 |
| Last Update Date | 2024-02-02 |