| NPI | 1083667745 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP110203) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX TX244561) |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2019-04-17 |