| NPI | 1659096873 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TN 32735) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 32735) |
| Enumeration Date | 2022-10-10 |
| Last Update Date | 2023-04-27 |