| NPI | 1164031258 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1016447) | 
| Additional Taxonomies | 163WE0003X Registered Nurse, Emergency (Licence: TX 865593) | 
| Enumeration Date | 2020-07-24 | 
| Last Update Date | 2021-09-18 |