| NPI | 1124422597 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NM 53252) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126422) |
| Enumeration Date | 2014-10-14 |
| Last Update Date | 2018-11-01 |