| NPI | 1063768737 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP122206) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 725588) |
| Enumeration Date | 2012-07-31 |
| Last Update Date | 2023-06-07 |