| NPI | 1932629813 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP142580) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: ND R41288) | 
| Enumeration Date | 2017-06-22 | 
| Last Update Date | 2022-08-29 |