| NPI | 1043203581 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 603779) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: OR 201500551NP-PP) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2016-08-20 |