| NPI | 1205107273 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX AP120987) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: TX 739050) |
| Enumeration Date | 2012-01-23 |
| Last Update Date | 2022-03-09 |