| NPI | 1861025603 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1137589)  | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 801939)  | 
| Enumeration Date | 2020-02-20 | 
| Last Update Date | 2023-11-01 |