| NPI | 1508440959 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: UT 7317231-4405) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: UT 7317231-3102) | 
| 363LF0000X Nurse Practitioner, Family (Licence: UT 7317231-4405) | |
| Enumeration Date | 2021-05-11 | 
| Last Update Date | 2025-05-21 |