| NPI | 1780305409 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: KY 4011266) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1093610) |
| Enumeration Date | 2022-09-09 |
| Last Update Date | 2024-12-14 |