| NPI | 1073946620 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 771897) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP123920) |
| Enumeration Date | 2013-08-19 |
| Last Update Date | 2019-08-19 |