| NPI | 1275040776 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP142472)  | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 56275)  | 
| 363LF0000X Nurse Practitioner, Family (Licence: FL 9466740)  | |
| Enumeration Date | 2018-01-05 | 
| Last Update Date | 2024-09-24 |