| NPI | 1184359762 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1153490) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: IL 209.025344) | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL APRN21017493) | |
| Enumeration Date | 2022-07-19 | 
| Last Update Date | 2024-11-07 |