| NPI | 1912254566 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP122235) | 
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP122235) | 
| 363L00000X Nurse Practitioner (Licence: TX 737292) | |
| Enumeration Date | 2012-08-13 | 
| Last Update Date | 2023-08-24 |