| NPI | 1649835968 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX 1128845) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MD R204833) |
| Enumeration Date | 2019-05-02 |
| Last Update Date | 2026-03-30 |