| NPI | 1710012661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP120063) |
| Additional Taxonomies | 208G00000X Thoracic Surgery (Cardiothoracic Vascular Surgery) (Licence: TX 120063) |
| 282N00000X General Acute Care Hospital (Licence: TX 120063) | |
| 363LA2100X Nurse Practitioner, Acute Care (Licence: MA 255220) | |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2022-05-05 |