| NPI | 1689221855 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8924546-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 8924546-3102) |
| Enumeration Date | 2019-08-22 |
| Last Update Date | 2019-08-27 |