| NPI | 1326717174 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1196536) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: TX 1196536) |
| 363LF0000X Nurse Practitioner, Family (Licence: AK 181682) | |
| Enumeration Date | 2021-09-07 |
| Last Update Date | 2026-09-22 |