| NPI | 1053601427 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 798161) | 
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: CA 703742) | 
| 363LF0000X Nurse Practitioner, Family (Licence: CA 19122) | |
| Enumeration Date | 2011-04-19 | 
| Last Update Date | 2016-06-02 |