| NPI | 1063787026 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP121531) | 
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 672302) | 
| Enumeration Date | 2012-03-09 | 
| Last Update Date | 2019-01-14 |