| NPI | 1063907772 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care (Licence: TX AP138568) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP138568) |
| Enumeration Date | 2018-06-25 |
| Last Update Date | 2025-11-28 |