| NPI | 1962142422 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 872200070) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: FL 872200070) |
| Enumeration Date | 2022-03-31 |
| Last Update Date | 2025-06-03 |