| NPI | 1366831612 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP126871) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 622606) |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP126871) | |
| Enumeration Date | 2015-01-09 |
| Last Update Date | 2023-03-02 |