| NPI | 1134627888 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1121098) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1121098) | 
| Enumeration Date | 2018-01-29 | 
| Last Update Date | 2024-01-10 |