| NPI | 1164154589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 1203383) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: AZ 276693) |
| Enumeration Date | 2022-06-24 |
| Last Update Date | 2025-11-16 |