| NPI | 1205358348 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1001196) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 22806) | 
| Enumeration Date | 2017-07-11 | 
| Last Update Date | 2022-11-30 |