| NPI | 1720811763 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: IA A183915) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1172559) |
| Enumeration Date | 2024-08-23 |
| Last Update Date | 2025-05-01 |