| NPI | 1619358611 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 6591001-4405) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: UT 6591001-8900) |
| Enumeration Date | 2015-06-15 |
| Last Update Date | 2018-06-14 |