| NPI | 1528148129 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 790762) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN APN11532) |
| Enumeration Date | 2006-10-17 |
| Last Update Date | 2023-03-07 |