| NPI | 1336735240 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1032120)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 767068)  | 
| Enumeration Date | 2020-12-15 | 
| Last Update Date | 2022-05-18 |