| NPI | 1174522312 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 593720) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX AP106950) |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2018-06-25 |