| NPI | 1104299189 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129621) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM CNP-02775) | 
| Enumeration Date | 2015-11-12 | 
| Last Update Date | 2025-09-10 |