| NPI | 1902187875 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1990) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: WI 4513) |
| Enumeration Date | 2011-09-06 |
| Last Update Date | 2019-10-15 |