| NPI | 1669400552 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: UT 291159-4405) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner Pediatrics (Licence: UT 291159-8900) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2024-05-23 |