| NPI | 1053807768 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP136741) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP136741) | 
| Enumeration Date | 2018-07-05 | 
| Last Update Date | 2024-08-05 |