| NPI | 1164261590 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1164309) | 
| Additional Taxonomies | 163WM0102X Registered Nurse, Maternal Newborn (Licence: TX 978487) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX 1164309) | |
| Enumeration Date | 2024-05-24 | 
| Last Update Date | 2025-08-29 |