| NPI | 1972120574 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1026698)  | 
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX 1026698)  | 
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2020-06-30 | 
| Last Update Date | 2023-01-11 |