| NPI | 1578086740 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 5232048-4405) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: UT 5232048-4405) |
| 163W00000X Registered Nurse (Licence: UT 5232048) | |
| Enumeration Date | 2017-07-19 |
| Last Update Date | 2022-06-01 |