| NPI | 1629674312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1002205) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WA AP61084529) |
| 363L00000X Nurse Practitioner (Licence: CA 95015518) | |
| 363L00000X Nurse Practitioner (Licence: NV 832139) | |
| Enumeration Date | 2020-12-08 |
| Last Update Date | 2020-12-08 |