| NPI | 1598650103 |
|---|---|
| Entity Type | Individual |
| Gender | N/A |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1203400) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 738009) |
| Enumeration Date | 2025-06-12 |
| Last Update Date | 2025-10-02 |