| NPI | 1003476789 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2085R0001X (Licence: TX 841606) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP141881) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2026-02-07 |