| NPI | 1639833817 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1071071) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 892717) |
| Enumeration Date | 2021-10-25 |
| Last Update Date | 2022-02-15 |