| NPI | 1104301860 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP138980) |
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP138980) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP138980) | |
| Enumeration Date | 2018-09-28 |
| Last Update Date | 2025-09-30 |