| NPI | 1689339608 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1058125) |
| Additional Taxonomies | 208100000X Physical Medicine & Rehabilitation (Licence: TX 1058125) |
| Enumeration Date | 2021-11-04 |
| Last Update Date | 2025-12-03 |