| NPI | 1962854604 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KS 76813) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 1175851) |
| Enumeration Date | 2016-07-06 |
| Last Update Date | 2026-03-25 |