| NPI | 1154629798 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP120067) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120067) | 
| 364SF0001X Clinical Nurse Specialist, Family Health (Licence: TX 692645) | |
| Enumeration Date | 2011-03-07 | 
| Last Update Date | 2021-11-28 |