| NPI | 1083190789 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1027622)  | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: NV 811112)  | 
| Enumeration Date | 2018-07-16 | 
| Last Update Date | 2025-03-28 |