| NPI | 1023456076 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP133135) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: LA 129442) |
| 363LF0000X Nurse Practitioner, Family (Licence: LA AP07379) | |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2018-06-06 |