| NPI | 1740950369 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1073403) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2021037181) | 
| Enumeration Date | 2021-09-15 | 
| Last Update Date | 2023-04-30 |