| NPI | 1124256649 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner Family (Licence: NC 191000) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: NC 191000) |
| 363L00000X Nurse Practitioner (Licence: TX AP145075) | |
| 363LF0000X Nurse Practitioner Family (Licence: TX AP145075) | |
| Enumeration Date | 2009-06-23 |
| Last Update Date | 2020-08-17 |