| NPI | 1215698659 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1064483) | 
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 1064483) | 
| Enumeration Date | 2022-01-07 | 
| Last Update Date | 2025-07-25 |