| NPI | 1790535359 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1170843) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: VA 0024189795) |
| Enumeration Date | 2024-03-26 |
| Last Update Date | 2025-07-29 |