| NPI | 1649919861 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1085604) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX F05220724) |
| 208100000X Physical Medicine & Rehabilitation (Licence: TX 1085604) | |
| Enumeration Date | 2022-06-04 |
| Last Update Date | 2025-12-03 |