| NPI | 1063878189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 800843) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP028307) | 
| 363LF0000X Nurse Practitioner, Family (Licence: MD AC004392) | |
| Enumeration Date | 2016-01-05 | 
| Last Update Date | 2025-08-29 |