| NPI | 1164865564 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP122819) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: LA AP07101) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 823212) | |
| Enumeration Date | 2013-04-16 |
| Last Update Date | 2020-10-01 |