| NPI | 1003274804 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP129548) | 
| Additional Taxonomies | 364SF0001X Clinical Nurse Specialist, Family Health (Licence: TX AP129548) | 
| Enumeration Date | 2016-02-08 | 
| Last Update Date | 2016-02-08 |