| NPI | 1366831612 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP126871) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP126871) | 
| 363LF0000X Nurse Practitioner, Family (Licence: TX 622606) | |
| Enumeration Date | 2015-01-09 | 
| Last Update Date | 2025-07-16 |