| NPI | 1164701504 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP128273) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 790531) |
| 163W00000X Registered Nurse (Licence: CA 759417) | |
| Enumeration Date | 2011-08-16 |
| Last Update Date | 2015-06-16 |