| NPI | 1962863498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP131402) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TN 38191) |
| 363L00000X Nurse Practitioner (Licence: AZ 289344) | |
| 363L00000X Nurse Practitioner (Licence: AL 3-002207) | |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2025-03-04 |