| NPI | 1962789651 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TN 16245) | 
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 1068733) | 
| Enumeration Date | 2011-11-08 | 
| Last Update Date | 2022-05-03 |