| NPI | 1194205203 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP138505) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX AP138505) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2022-12-19 |