| NPI | 1972097491 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 137803) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA 222109) |
| Enumeration Date | 2018-06-18 |
| Last Update Date | 2025-03-14 |