| NPI | 1609275536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP125694) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ TELE293036) |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2024-05-08 |