| NPI | 1083751762 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP109591) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner Family (Licence: TX AP109591) |
| 363LF0000X Nurse Practitioner Family (Licence: TX 554347) | |
| Enumeration Date | 2007-01-31 |
| Last Update Date | 2019-08-16 |