| NPI | 1104136316 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 249415) |
| Additional Taxonomies | 207QA0505X Family Medicine, Adult Medicine (Licence: TX 249415) |
| Enumeration Date | 2010-10-21 |
| Last Update Date | 2011-06-15 |