| NPI | 1619728664 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1155365)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 738554)  | 
| Enumeration Date | 2024-03-28 | 
| Last Update Date | 2024-03-29 |