| NPI | 1922872274 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 10069868-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 10069868-3102) |
| Enumeration Date | 2023-11-07 |
| Last Update Date | 2024-05-06 |