| NPI | 1740340488 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 036133621) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 593352) | 
| Enumeration Date | 2006-12-11 | 
| Last Update Date | 2025-09-11 |