| NPI | 1194903179 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 650735) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: TX AP115709) |
| 363LF0000X Nurse Practitioner, Family (Licence: TX 650735) | |
| Enumeration Date | 2008-02-01 |
| Last Update Date | 2018-12-20 |