| NPI | 1053873661 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1123745) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 913917) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2024-06-20 |