| NPI | 1104986074 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP112532) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 617058) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2020-10-29 |