| NPI | 1790111557 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 123843) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NM 68821) |
| 363LF0000X Nurse Practitioner, Family (Licence: CT 93280) | |
| 363L00000X Nurse Practitioner (Licence: NY 353528) | |
| 363LF0000X Nurse Practitioner, Family (Licence: CO 0101373) | |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2025-10-05 |