| NPI | 1962863498 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP131402) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AZ 289344) |
| Enumeration Date | 2016-03-10 |
| Last Update Date | 2024-05-07 |