| NPI | 1801384789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1168726) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 808112) | 
| Enumeration Date | 2018-04-26 | 
| Last Update Date | 2024-11-18 |