| NPI | 1790114700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LN0000X Nurse Practitioner, Neonatal (Licence: TX AP125442) | 
| Additional Taxonomies | 363LN0000X Nurse Practitioner, Neonatal (Licence: MT NUR-APRN-LIC-197650) | 
| 163W00000X Registered Nurse (Licence: TX 792617) | |
| Enumeration Date | 2013-11-11 | 
| Last Update Date | 2024-02-22 |