| NPI | 1104178037 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP122536) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 588871) |
| Enumeration Date | 2012-10-02 |
| Last Update Date | 2023-03-13 |