| NPI | 1659024222 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1047236) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX 1047236) |
| 363L00000X Nurse Practitioner (Licence: CA 95018836) | |
| Enumeration Date | 2022-02-02 |
| Last Update Date | 2023-08-01 |