| NPI | 1598309759 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1017848)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 897553)  | 
| Enumeration Date | 2019-10-31 | 
| Last Update Date | 2024-10-28 |