| NPI | 1861178352 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1127036) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 926582) |
| Enumeration Date | 2023-06-27 |
| Last Update Date | 2023-09-22 |