| NPI | 1639500788 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: WI 10178-33) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 848276) |
| Enumeration Date | 2013-11-27 |
| Last Update Date | 2022-05-25 |