| NPI | 1730735663 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: LA 206927) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 142967) |
| Enumeration Date | 2019-08-15 |
| Last Update Date | 2021-04-15 |