| NPI | 1013931732 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 559894) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OK 46651) | 
| Enumeration Date | 2006-07-26 | 
| Last Update Date | 2011-06-14 |