| NPI | 1124423124 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP126056) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 719144) |
| Enumeration Date | 2014-11-03 |
| Last Update Date | 2015-09-23 |