| NPI | 1003648312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1020822) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: FL APRN11033474) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2025-12-31 |