| NPI | 1114982030 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP110620) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 617399) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX AP110620) | |
| Enumeration Date | 2006-04-20 |
| Last Update Date | 2021-11-17 |