| NPI | 1801403654 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 2016013133) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: GA RN280432) |
| Enumeration Date | 2020-09-25 |
| Last Update Date | 2022-09-01 |