| NPI | 1962960021 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 0024176928) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: VA 0024176928) |
| Enumeration Date | 2019-03-07 |
| Last Update Date | 2026-03-26 |