| NPI | 1831557982 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX F06180743)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 845837)  | 
| Enumeration Date | 2016-02-04 | 
| Last Update Date | 2020-06-05 |