| NPI | 1396419800 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1052248) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 10003790) |
| Enumeration Date | 2021-08-07 |
| Last Update Date | 2026-07-10 |