| NPI | 1861974487 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1176637) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 967653) |
| 164X00000X Licensed Vocational Nurse (Licence: TX 343492) | |
| Enumeration Date | 2018-08-30 |
| Last Update Date | 2024-10-08 |