| NPI | 1699264531 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: VA 0024184466) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 821736) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP138129) | |
| Enumeration Date | 2018-05-07 | 
| Last Update Date | 2024-06-25 |