| NPI | 1649818832 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1195994) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MA RN2265530) |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2025-08-05 |