| NPI | 1578929949 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: PA SP025676) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP129902) |
| 363LA2200X Nurse Practitioner, Adult Health (Licence: WA AP60658038) | |
| Enumeration Date | 2016-01-14 |
| Last Update Date | 2022-09-22 |