| NPI | 1164569737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1233609) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 45671) |
| 363L00000X Nurse Practitioner (Licence: IA A132762) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2026-08-10 |