| NPI | 1114210648 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 798878) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: PA SP010939) |
| Enumeration Date | 2011-05-17 |
| Last Update Date | 2014-10-16 |