| NPI | 1760083893 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1016762) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX 1016762) | 
| Enumeration Date | 2020-11-04 | 
| Last Update Date | 2022-04-05 |