| NPI | 1639631930 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP142407) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 892821) | 
| 363L00000X Nurse Practitioner (Licence: TX 892821) | |
| Enumeration Date | 2019-04-04 | 
| Last Update Date | 2022-06-04 |