| NPI | 1164950283 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX F05170039) |
| Additional Taxonomies | 208D00000X General Practice (Licence: TX AP134113) |
| Enumeration Date | 2017-06-02 |
| Last Update Date | 2025-04-07 |