| NPI | 1073893335 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 642204) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120757) |
| Enumeration Date | 2011-08-18 |
| Last Update Date | 2017-05-26 |