| NPI | 1750274700 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1179445) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 14102973) | 
| Enumeration Date | 2025-05-29 | 
| Last Update Date | 2025-05-29 |