| NPI | 1851793459 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP134679) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TN 19207) | 
| Enumeration Date | 2014-09-25 | 
| Last Update Date | 2022-07-21 |