| NPI | 1760104582 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1111592) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: CA 95021682) |
| Enumeration Date | 2022-09-19 |
| Last Update Date | 2025-07-18 |