| NPI | 1114650884 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1075599) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX 1075599) |
| Enumeration Date | 2022-07-08 |
| Last Update Date | 2025-07-31 |