| NPI | 1104897149 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP111656) |
| Additional Taxonomies | 363LA2100X Nurse Practitioner Acute Care (Licence: TX 542986) |
| 363LA2200X Nurse Practitioner Adult Health (Licence: TX 542986) | |
| Enumeration Date | 2006-01-28 |
| Last Update Date | 2022-03-04 |