| NPI | 1134127160 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: NM CNP-02049) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX 241078) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 241078) | |
| 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 241078) | |
| 363L00000X Nurse Practitioner (Licence: TX AP110588) | |
| Enumeration Date | 2005-07-13 |
| Last Update Date | 2019-01-15 |