| NPI | 1619728664 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: TX 1155365) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 738554) |
| Enumeration Date | 2024-03-28 |
| Last Update Date | 2024-03-29 |