| NPI | 1104282920 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP129597) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: CA 95003474) |
| Enumeration Date | 2016-01-08 |
| Last Update Date | 2018-02-01 |