| NPI | 1376112284 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1045569)  | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 1045569)  | 
| Enumeration Date | 2021-06-24 | 
| Last Update Date | 2024-03-07 |