| NPI | 1699173161 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: WY 50968) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP138235) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2022-12-07 |