| NPI | 1073877460 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LX0001X Nurse Practitioner Obstetrics & Gynecology (Licence: TX 238764) |
| Additional Taxonomies | 363LP0808X Nurse Practitioner Psychiatric/Mental Health (Licence: TX 238764) |
| Enumeration Date | 2012-06-29 |
| Last Update Date | 2018-12-19 |