| NPI | 1720440092 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP130637) |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: TX AP130637) |
| 261QM1300X Clinic/Center, Multi-Specialty (Licence: TX AP130637) | |
| Enumeration Date | 2016-03-24 |
| Last Update Date | 2025-06-26 |