| NPI | 1033905112 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: TX 691675) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 95074602) |
| Enumeration Date | 2025-04-16 |
| Last Update Date | 2025-06-20 |