| NPI | 1255841706 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP135410) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP135410) | 
| 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP135410) | |
| Enumeration Date | 2017-10-10 | 
| Last Update Date | 2023-04-11 |