| NPI | 1205691029 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1194777) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: MA RN2343792) |
| Enumeration Date | 2024-02-20 |
| Last Update Date | 2025-09-16 |