| NPI | 1063703510 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX AP119719) |
| Additional Taxonomies | 363LP2300X Nurse Practitioner, Primary Care (Licence: TX 639757) |
| Enumeration Date | 2011-05-02 |
| Last Update Date | 2019-01-30 |