| NPI | 1295344422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1095562) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: KS 53-79639-092) |
| 163W00000X Registered Nurse (Licence: KS 13-131530-092) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: TX 1095562) | |
| 363LA2200X Nurse Practitioner Adult Health (Licence: KS 53-79639-092) | |
| Enumeration Date | 2020-07-23 |
| Last Update Date | 2025-07-31 |