| NPI | 1225225808 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 363L00000X Nurse Practitioner (Licence: TX 246541) | 
| Additional Taxonomies | 363LC1500X Nurse Practitioner, Community Health (Licence: TX 246541) | 
| Enumeration Date | 2007-09-27 | 
| Last Update Date | 2015-04-08 |