| NPI | 1174802169 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX AP120786) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: TX 729612) |
| 247200000X | |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2014-11-21 |