| NPI | 1164420501 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 691578) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AR AO1521) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2018-06-11 |