| NPI | 1184677221 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 705092) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: GA RN149434) | 
| Enumeration Date | 2006-05-18 | 
| Last Update Date | 2024-03-21 |