| NPI | 1609275536 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP125694) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CO C-APN.0103363-C-NP) |
| 363L00000X Nurse Practitioner (Licence: OH 0026991) | |
| 363L00000X Nurse Practitioner (Licence: MO 2024032201) | |
| 363L00000X Nurse Practitioner (Licence: AZ TELE293036) | |
| Enumeration Date | 2014-08-15 |
| Last Update Date | 2024-12-12 |