| NPI | 1093765463 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 108002) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 569740) |
| Enumeration Date | 2006-05-10 |
| Last Update Date | 2014-07-08 |