| NPI | 1174712905 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 680098) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: TX 680098) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 680098) | |
| Enumeration Date | 2007-10-17 |
| Last Update Date | 2018-10-24 |