| NPI | 1104028554 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 125933) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA APO5164) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2015-01-19 |