| NPI | 1649800699 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1114211) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: HI 95646) | 
| Enumeration Date | 2020-01-17 | 
| Last Update Date | 2023-06-16 |