| NPI | 1073903589 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP127489) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 801188) |
| Enumeration Date | 2015-02-04 |
| Last Update Date | 2015-05-11 |