| NPI | 1073519260 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 759632) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 45590) |
| Enumeration Date | 2005-06-22 |
| Last Update Date | 2012-08-14 |