| NPI | 1629777578 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1193521) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 859256) |
| Enumeration Date | 2023-03-01 |
| Last Update Date | 2025-04-01 |