| NPI | 1588015366 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 81600884405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 81600883102) |
| Enumeration Date | 2016-06-23 |
| Last Update Date | 2021-10-19 |