| NPI | 1710587332 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 3852485-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 98524853102) |
| Enumeration Date | 2020-11-01 |
| Last Update Date | 2021-09-22 |