| NPI | 1205504156 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 12730574-4405) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 859150) |
| Enumeration Date | 2021-09-03 |
| Last Update Date | 2026-02-26 |