| NPI | 1659320240 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: UT 223122-4405) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner Adult Health (Licence: UT 223122-4405) |
| 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 223122-4405) | |
| 363L00000X Nurse Practitioner (Licence: UT 223122-4405) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2021-12-20 |