| NPI | 1962132803 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1088322) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 826875) |
| Enumeration Date | 2022-06-14 |
| Last Update Date | 2023-06-14 |