| NPI | 1962950113 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner Acute Care (Licence: TX 1058064) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1058064) |
| 363L00000X Nurse Practitioner (Licence: IN 71006614A) | |
| Enumeration Date | 2016-09-16 |
| Last Update Date | 2022-01-28 |