| NPI | 1083010763 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX AP125673) | 
| Additional Taxonomies | 363LA2100X Nurse Practitioner, Acute Care (Licence: TX AP125673) | 
| 363LG0600X Nurse Practitioner, Gerontology (Licence: TX AP125673) | |
| Enumeration Date | 2014-11-07 | 
| Last Update Date | 2014-11-07 |