| NPI | 1063833754 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LC1500X Nurse Practitioner, Community Health (Licence: TX 731144) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP123456) |
| Enumeration Date | 2013-12-23 |
| Last Update Date | 2026-01-27 |