| NPI | 1629812797 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1159006) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 79706) |
| Enumeration Date | 2024-06-24 |
| Last Update Date | 2025-08-14 |