| NPI | 1417723362 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1208263) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2023031632) |
| Enumeration Date | 2023-12-01 |
| Last Update Date | 2026-03-04 |