| NPI | 1023251535 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 793067) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: MO 2003003739) |
| Enumeration Date | 2009-04-14 |
| Last Update Date | 2012-09-12 |