| NPI | 1104259308 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 1157553) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: ID 4261979) |
| Enumeration Date | 2013-08-12 |
| Last Update Date | 2024-09-04 |