| NPI | 1124500780 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: FL 11012124) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP138587) |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2026-01-09 |