| NPI | 1235486002 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: TX 730861) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: NY F337217) |
| Enumeration Date | 2012-08-10 |
| Last Update Date | 2015-01-21 |