| NPI | 1730886557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 8530588-4405) |
| Additional Taxonomies | 204E00000X Oral & Maxillofacial Surgery (Licence: UT 8530588-4405) |
| Enumeration Date | 2023-02-13 |
| Last Update Date | 2023-04-18 |