| NPI | 1548808603 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP143786) | 
| Additional Taxonomies | 208200000X Plastic Surgery (Licence: TX AP143786) | 
| Enumeration Date | 2019-12-19 | 
| Last Update Date | 2023-10-25 |